Relationships between neighborhood disadvantage and cardiovascular findings at autopsy in subjects with sudden death.
Background: Neighborhood disadvantage is associated with a higher risk of sudden cardiac death. However, autopsy findings have never been investigated in this context. Here, we sought to explore associations between neighborhood disadvantage and cardiovascular findings at autopsy in cases of sudden...
| Publicado en: | American Heart Journal Vol. 256; pp. 37 - 51 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Feb2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161276379&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161276379 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00028703 04K jtl: American Heart Journal issn: 00028703 maglogo: N pubinfo: dt: Feb2023 vid: 256 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 161276379 161276379 NLM36372247 10.1016/j.ahj.2022.10.086 NLM36372247 161276379 ppf: 37 ppct: 14 formats: tig: atl: Relationships between neighborhood disadvantage and cardiovascular findings at autopsy in subjects with sudden death. aug: au: Cornelissen, Anne Guo, Liang Neally, Sam J. Kleinberg, Leah Forster, Ashley Nair, Rajeev Gadhoke, Neel Ghosh, Saikat Kumar B. Sakamoto, Atsushi Sato, Yu Kawakami, Rika Mori, Masayuki Kawai, Kenji Fernandez, Raquel Dikongue, Armelle Abebe, Biniyam Kutys, Robert Romero, Maria E. Kolodgie, Frank D. Baumer, Yvonne affil: CVPath Institute, Gaithersburg, MD, US sug: ab: Background: Neighborhood disadvantage is associated with a higher risk of sudden cardiac death. However, autopsy findings have never been investigated in this context. Here, we sought to explore associations between neighborhood disadvantage and cardiovascular findings at autopsy in cases of sudden death in the State of Maryland.Methods: State of Maryland investigation reports from 2,278 subjects within the CVPath Sudden Death Registry were screened for street addresses and 9-digit zip codes. Area deprivation index (ADI), used as metric for neighborhood disadvantage, was available for 1,464 subjects; 650 of whom self-identified as Black and 814 as White. The primary study outcome measurements were causes of death and gross and histopathologic findings of the heart.Results: Subjects from most disadvantaged neighborhoods (i.e., ADI ≥ 8; n = 607) died at younger age compared with subjects from less disadvantaged neighborhoods (i.e., ADI ≤ 7; n = 857; 46.07 ± 14.10 vs 47.78 ± 13.86 years; P = 0.02) and were more likely Black or women. They were less likely to die from cardiac causes of death (61.8% vs 67.7%; P = 0.02) and had less severe atherosclerotic plaque features, including plaque burden, calcification, intraplaque hemorrhage, and thin-cap fibroatheromas. In addition, subjects from most disadvantaged neighborhoods had lower frequencies of plaque rupture (18.8% vs 25.1%, P = 0.004). However, these associations were omitted after adjustment for traditional risk factors and race.Conclusion: Neighborhood disadvantage did not associate with cause of death or coronary histopathology after adjustment for cardiovascular risk factors and race, implying that social determinants of health other than neighborhood disadvantage play a more prominent role in sudden cardiac death. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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